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Hip dysplasia is an abnormal formation of the hip socket. In its more severe form it can eventually cause crippling lameness and painful arthritis of the joints.  

It can be found in many animals as well as in humans, but is most commonly associated with dogs, and is common particularly in the larger breeds.

Hip dysplasia is one of the most studied veterinary conditions in dogs, and the most common single cause of arthritis of the hips. It is a genetic (polygenic) trait that is affected by environmental factors.

HIP DYSPLASIA

Dysplasia in dogs can be caused by poorly developed muscles in the pelvic area or a femur that does not fit correctly into the pelvic socket. Large and giant breeds are most susceptible to hip dysplasia, it is believed  that the BMI (body - mass - index) of the individual animal plays a large role, though, many other breeds can suffer from it.

New research conclusively suggests that environment also plays a role, whilst hip dysplasia are considered heritable. Precisely to what degree the causality is genetic and what portion environmental is a topic of current debate. Environmental influences include an overweight condition, injury at a young age, overexertion on hip joint at a young age, ligament tear at a young age, repetitive motion on forming joint (jogging with puppy under the age of 1 year)

For a list of top 100 breeds affected, by percentage, visit the OFFA Here: http://www.offa.org/stats_hip.html.

To reduce pain, the dog will typically reduce its movement of the problem hip. Some dogs will develop what is often called  "bunny hopping", where both legs move together, or reduce unnecessary movement such as running, jumping, whilst stiffness is a universal trait. Since the hip cannot move fully, the body compensates by adapting its use of the spine, and in turn cause spinal stifle (a dog's knee joint) or other soft tissue problems to arise.

The problem almost always appears by the time the dog is 18 months old. The defect can be anywhere from mild to severely crippling, and can eventually cause severe osteoarthritis.

Symptoms

Dogs might exhibit signs of stiffness or soreness after rising from rest, reluctance to exercise or stand on rear legs, bunny-hopping or abnormal gait, lameness, pain when climbing stairs or jumping up, and difficulty in climbing stairs.

Wasting away of the muscle mass in the hip region will often confirm the presence of hip dysplasia, but radiographic features may not be present until two years of age in some dogs. To add to the problems, many affected dogs do not show clinical signs, but some dogs manifest the problem before seven months of age, whilst other dogs do not show it until well into adulthood!

In part this is because the underlying hip problem may be mild or severe, may be worsening or stable, and the body may be more or less able to keep the joint in repair well enough to cope. Also, different dogs have different pain tolerances, and use their bodies differently. Certain dogs will have visible problems early on, others may never actually show as having a real problem at all.

Long term pain

A dysplastic animal has probably lived with the condition since it was only a few months old, and has therefore grown up taking the pain for granted and has learnt to live with it.

Dogs suffering such pain do not usually exhibit acute signs of pain. Sometimes, they will suddenly and abnormally sit down when walking, or refuse to walk or climb onto objects they usually would without a second thought, but this can equally be a symptom of many other things, including a thorn in the paw, or a temporary muscle pain.

Therefore, recognising when your dog is suffering pain becomes extremely important so as not to misdiagnose the cause.        

The classic diagnostic technique is with x-rays and hip scoring tests. These should be done at an appropriate age and repeated at adulthood as if done too young, they will probably not show anything abnormal.

Since the condition is to a large degree inherited, the hip scores of parents should be professionally checked before buying a pup, and the hip scores of dogs should be checked before relying upon them for any breeding purposes.

Despite the fact that the condition is inherited, it can arise in dogs with impeccable hip scored parents.

In diagnosing suspected dysplasia, the x-ray to evaluate the internal state of the joints is usually combined with a study of the animal and how it moves, to confirm whether its quality of life is being affected.

Evidence of lameness or abnormal hip or spine use, difficulty or reduced movement when running or navigating steps, are all evidence of a problem. Both aspects have to be taken into account since there can be serious pain with little X-ray evidence.

There are several standardized systems for categorising dysplasia, set out by respective reputable bodies (Orthopedic Foundation for Animals / OFA, Penn HIP,  British Veterinary Association/BVA). Some of these tests require manipulation of the hip joint into standard positions, in order to reveal their condition on an X-ray.

Certain conditions can mimic or replicate the symptoms of hip dysplasia

The following conditions can give symptoms very similar to hip dysplasia, and should be ruled out during diagnosis:

Cranial (anterior) cruciate ligament tears

Cauda equina syndrome (i.e. lower back problems)

Osteochondritis dissecans and elbow dysplasia in the forelimbs are difficult to diagnose as the dog may only exhibit an unusual gait.

It is also worth noting that a dog may misuse its rear legs, or adapt its gait, to compensate for pain in the forelimbs, notably osteoarthritis, osteochondritis OCD and shoulder or elbow dysplasia, as well as pain in the hocks and stifles or spinal issues. It is important to rule out other joint and bodily issues before concluding that only hip dysplasia is present.

Even if some hip dysplasia is present, it is possible for other conditions to co-exist or be masked by it.

Overview

There is no complete cure, although there are many options to alleviate the clinical signs.

The aim of treatment is to enhance quality of life, but crucially, this is an inherited and degenerative condition and so will change during the course of the dog's life, so any treatment is subject to regular review or re-assessment if the symptoms appear to get worse or anything changes significantly.

If the problem is relatively mild, then sometimes all that is needed to bring the symptoms under control are suitable medications to help the body deal better with inflammation, pain and joint wear.

If the problem cannot be controlled with medications, then often surgery is considered. There are traditionally two types of surgery;

1. Surgery to reshape the joint to reduce pain.

2. Total hip replacement to completely replace the damaged joint.

Non-surgical interventions

Non-surgical interventions ranges over three elements: weight control, exercise control, and medication.

Non-surgical intervention is usually via a suitable non steroid anti-inflammatory drug, often acting as a painlkiller.

There are several glucosamine based supplements which may give the body additional raw materials used in joint repair. Glucosamine can take 3–4 weeks to start showing its effects, so the trial period for medication is usually at least 3–5 weeks.

Some attempts have been made to treat the pain caused by arthritic changes through the use of "laser therapy", in particular "class IV laser therapy". Controlled clinical trials are unfortunately lacking in this field, and much of the evidence for these procedures remains anecdotal.

Surgical interventions

If medications fail to maintain an adequate quality of life, surgical options may need to be considered. These may attempt to modify or repair the hip joint, in order to allow pain free usage, or may in some cases completely replace it.

Hip modification surgeries include excision arthropplasty, in which the head of the femur is removed and reshaped or replaced, and pelvic rotation (also known as triple pelvic osteotomy, or pubic symphodesis) in which the hip socket is realigned, may be appropriate if done early enough.

These treatments can be very effective, but as a rule tend to become less effective for heavier animals - their ability to treat the problem becomes reduced if the joint has to handle more pressure in daily life.

Pelvic rotation is also not as effective if arthritis has developed to the point of being visible on X-rays.

Femoral head ostectomy (FHO), sometimes appropriate for smaller dogs and cats, is when the head of the femur is removed but not replaced. Instead, the resulting scar tissue from the operation takes the place of the hip joint. In such surgeries, the weight of the animal must be kept down throughout its life in order to maintain mobility.

FHO surgery is sometimes done when other methods have failed, but is also done initially when the joint connection is particularly troublesome or when arthritis is severe.

Hip modification surgeries such as these usually result in reduction of hip function in return for improved quality of life, pain control, and a reduction in future risk.

Hip replacement has the highest rate of success, especially in severe cases, since it completely replaces the faulty joint. It usually restores complete mobility if no other joint is affected, and also completely prevents recurrence.

Hip replacement for dogs, can sometimes also be a preferred clinical option for serious dysplasia in animals over about 40–60 lb (18–27 kg), a weight that excludes certain other surgical treatments.

hip dysplaysia

In the normal anatomy of the hip joint, the 'root' (thigh bone) is connectedhip dysplaysia to the pelvis at the hip joint.

The almost spherical end of the femur head fits into the acetabulum, the concave socket located in the pelvis.

The bony surface of the femur head and of the acetabulum are covered by cartilage, so whilst bones provide the strength necessary to support body weight, cartilage ensures a smooth fit and a wide range of motion.

Normal hip function can be affected by congenital conditions such as dysplasia, trauma, and by acquired diseases such as osteoarthritis and rheumatoid arthritis.

In a hip suffering from dysplasia, two things are commonly abnormal.

Firstly, the caput is not deeply and tightly held by the acetabulum, instead of it being a tight, snug fit, it is loose, or a partial fit.

Secondly, the caput or acetabulum is not smooth and round, causing abnormal wear and tear together with friction within the joint as it moves.

The body auto-reacts to this in several ways. The joint itself is continually repairing itself and laying down new cartilage, however, cartilage repair is a relatively slow process, so the joint can continue to suffer degradation due to the abnormal wear and tear, or may not support the body weight as intended and fails altogether.

The failing joint becomes inflamed whilst a cycle of cartilage repair - damage - inflammation  and  pain, commences. This sadly becomes a common process resulting in the joint becoming even more damaged as it is unable to fight off and resist further damage.

The inflammation itself causes huge damage, the bones of the joint risk developing osteoarthritis, shows on x-rays as small outcrops of bone around the edge of the damaged joint, that in itself  again further degrades the joint..

There are no straight lines followed by disease, the deformity of the joint may get worse over time, or remain static. The dog may show positive X-rays and yet be in immense pain, or it may have negative X-rays and show no pain. The hip condition is only one factor to determine the extent to which dysplasia is causing pain or affecting the quality of life.

Normal hip anatomy

hip dysplaysia

Causes and effects

Clinical detection and testing

Dysplastic hip anatomy

hip dysplaysia

Moderate Dysplasia

Normal Hip

Severe Dysplasia

Each case must be treated on its own merits accordingly, and a wide range of treatment options exist

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Diagnosis and Avoidance

Treatment

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Hydrotherapy is a common post-op therapy.

Hydrotherapy is often tried as a therapy before any invasive surgical treatment is undertaken.

hip dysplaysia hip dysplaysia hip dysplaysia

Once again it cannot be stressed strongly enough, the diagnosis and treatment for any health issue with your dog can only ever be carried out by a veterinarian.

The well being of your dog is too important not to get the best possible care.  We have seen numerous owners taking diagnosis into their own hands with tragic consequences.